Bert kuatjxt



(No Model.) 2 Shee'ss--Sheei'l l.

A. E. A. RUAULT. SURGICAL ASPIRATOR, sw.

N0. 350,895. Patented Oct. 12, 1886.

1b l? u 'A 3 E* .'1.' .fulwftifvil 1| FIGB.

FIGA-- 2 Sheets- Sheet 2.

(No Model.)

A. E. A. RUAULT.

SURGICAL AsPIRAToR, 6m.

No. 350,895. E06 Patented Oct. 12, 1886.

N. PETERS, Pvwwmhognpher, washingwn. D4 C.

Nrrsn STATES ARMAND EDOUARD ALBERT RUAULT, OF PARIS, FRANCE.

SURGICAL ASPIRATOR, 80C.

SPECIFICATION forming parl; of Letters Patent No.350,895, dated October 12,1886.

Application filfd January Q0, 1886. Serial No. lFSLll.

To @ZZ whom, may concern:

Be it known that l, ARMAND EDOUARD AL- BERT RUAULT, a citizen of the Republic of France, residing at the city of Paris, France, have invented certain new and useful Im p'rovements in Surgical Aspirators, &c., fully described and represented in the following specification and the accompanying drawings, forming a part of the same.

Surgical instruments commonly known as exhausters, have proved in practice to be defectivein many respects, the chief of which is the use of a great number of cocks, which require caution and preciseness in their manipulation, and which are with diflicultyukept in order. Double-actingapparatusesemploying a combined exhausting and injecting pump have also been used by which a medicinal Huid can be injected into a cavity directly it has been exhausted by the apparatus of its morbid liquid, by connecting the apparatus with a second channel of the pump, which will then act as a force-pump, instead of by suction, a single bottle being employed. Such apparatus, while acting efficiently during the exhausting' operation, is more orless inefficient when operating as an injector by reason of the dangerof expelling the stopper with which the bottle employed in the apparatus is provided, and which in practice is guarded against by an assistant holding it in place. This apparatus, moreover, consists ol' many independ ent parts requiring time to tit together and caution in manipulation.

The object ofthe present invention is to provide a combined exhausting and injecting instrument, 'which shall overcome the objections to those heretofore employed, and which shall be simple in its structure, easy of manipulation, and eflieient in its op'eration.

In the drawings, Figure l is a front elevation, partly in section, of the improved instrument; Fig. 2, a plan view of the same, the piyoted beam for clamping the stoppers in place being removed for perspecuitys sake; Fig. 3, a sectional side elevation of the same, the pump being shown in its position on the apparatus while not in use. Fig. 4 is au enlarged side elevation ofthe controlling-valve, its case bcing shown in section. Fig. 5 is a vertical sectional elevation of a plug` or stopper of one (Xo model) Patented in FrunceDecembcr 1S, 1855. No. 160,362.

of the bottles, and Figs. 6, 7, S, and 9 are diagrams illustrating by two longitudinal sections and three cross-sectional views each, taken, respectively, on the lines 3, 4, and 5, Fig. 6, the four different positions of the controlling valve or cock.

Referring particularly to Figs. l to 5, inclusive, it is to be understood that the apparatus as therein illustrated consists of two bottles,l A B, one the suction and the other the injecting bottle, resting side by side upon a bed-piece, C, from which projects a hollow vertical post, D, that rises between the bottles to a height slightly lower than their mouths. Within this vertical post is arranged a vertically-adjustable rod, E, that is provided near its upper end wit-l1 a horizontally-arranged beam, l, pivoted thereto, and also with a controlling valve or cock, E, and a handle, M, for lifting' and carrying the instrument. The horizontal beam I projects from opposite sides of the rod Eover the mouths of the bottles A B, and isthere provided with plugs or stoppers K and L, respectively connected thereto through ball-and-socket joints a, and arranged so as to enter and rest upon the mouths of the bottles, as is clearly shown. The vertical rod E is connected at its lower end with a lever, F, fulcrumed at one end up on a stud projecting from the bed-picce ofthe instrument, its opposite end being engaged by a nut, N, on a screw-threaded rod, G, by which nut the lever and through it the rod E and beam l may be adj usted and forced downward, so as to securely confine the plugs or stoppers onto the mouths of the bottles, and thus they -may be simultaneously closed or opened, ac cording as the lever F is adjusted, and enablingthe bottles to be rapidly removed and replaced as occasion may require. The ballandsoel{et joints a permit the stcppers to adjust themselves to that ot' the mouths of the bottles, while, should the bottles varyslightly in height, the pivoted beam I will accommodate itself thereto.

The Stoppers K and L are of like construe tion. They consist of a cylinder, d, provided with a liauge, b, the under side ot' which is lined with an india-rubber washer, e, to rest upon the mouth of the bottle. The Stoppers are each provided with orilieesfg, communi- IOO eating with the interior of the bottle, and by suitable nozzles, m m, upon opposite sides of the stopper, with tubes connecting said orifices with the shell of the controlling-valve. rIhe orifice f of the stopper for the injecting-bottle will preferably have a nozzle, t', to which is attached an india-rubber tube, j, projecting into the bottle, as shown. The distributing cock or valve B is of cylindrical partly tapering shape, and is arranged at right angles to n the length of the beam I and to the plane lof the bottles A B. It is held in a shell or seat on the vertical rod E, which shell is provided with six orifices, 7c k', ZZ, and a a', three each on opposite sides thereof and in the plane of the axis of the valve. Theoritices 7c k and ll are each connected by suitable pipes or tubes with the nozzles m of the orifices f g of each stopper, as seen in Figs. 2, 6 to 9 ,whilethe orifices n n are each connected by suitables tubes, fr, to nozzles of a pump, H. The valve-shell is also provided with two air-orifices, p q, arranged near the head of the valve upon opposite sides of the shell and at right angles to the horizontal axis of the valve. The plug of the valve B has a longitudinal opening, o', extending a short distance in its stem, connected bya bayonet or other tight joint, s, with an india-rubber tube, the end of which is adapted to receive the instrument, (catheter, troehar, &c.,) which is to be inserted into the cavity to be acted upon by aspiration or injection. With this longitudinal opening connects an orifice, o, extending at right angles therefrom and in line, when the valve is rotated therefor, to coincide with either of the openings 7c 7c' of the shell, and thus either of the orifices f of the Stoppers K L may be put into communication with the tube t by turning the plug so as to present the orifice o in line with either one of the openings 7c 7c. The valveplug is provided with a channel, V, which is of such form that either one of the orifices a n may communicate with one of the air-orificesp q, and the plug is also provided with two short longitudinal channels, S T, that serve at stated times to connect the orifices u and l together, and likewise the orifices n and l together, so that the bottles may each be placed independentlyinto communication with the pump. This shell of the valve B preferably carries a stationary pawl orindex, XV, that engages with notches on the disk U, carried by the valve-plug, and which disk is provided with designating words or abreviations, as Raref,77 Exhaust, Compr., |Injeet.,7

' so that the plug may be instantly turned toa position to effect the proper connections with the channels and orifices for the operationsin which the instrument is to be employed. The pump His a single-acting one, its nozzles being provided with the ordinary valves, one opening inward' and one outward, and its piston actuated by ahandle, X, which, Whenthe pump is not in use, may be hooked on a support, Y, its bottom projectingstud, Z, fittingin a recess (not shown) in the top of the lever F, comy pleting the means for holding said pump and preventing it from swinging about when moved from place to place.

Referring to Figs. 6, 7', 8, and 9, it will be seen that the valve-plug B may occupy four different positions. In the first position-#that shown in Fig. t-thc air within the left-hand sucton-bottle, A, may be rari'fied upon actuating the pump in one direction, in which case the air will be drawn from the bottle through the stopper-orifice g, tube connecting it with orifeeZ, and by channel S of the valve-plug by tube-connecting orifices a and pump-'nozzle r to the pump, and on the reverse action of the pump-piston thewair thus withdrawn from the bottle Awill be expelled through pipe connecting the pump-nozzle r with orifice n', and the recess V in the valveplug to the open air by the air orifice p, communication between both the bottles and the tube t by the axial orifice o' being cut off vafs well as between the pump H and the injecting-bottle B, as is clearlyseen. In the second positionthat shown in Fig. 7-the valve-plug having been turned in the direction of the arrow, (see Fig. 6,) the pathological cavity into which the instrument at the end of the tube is projected will under- 1 go a direct exhaustion upon actuating the pump, in which case the axial orifice o and tube t will be brought into communication with the suction-bottle A through its radial orifice o and orifices k and f, and the tube connecting the two, while the other stopper-orifice, g, will still be in communication with the pump, but by means ,of the channel T,(the 'channel S having been moved to an idle position,) and the pump also in communication with the open air by means of the recess V, which in thisposition communicates with the air-orifice q. In the third position-that shown in Fig.

, 8--air may be compressed in the right-hand or ICO injecting bottle, B, by the action ofthe pump,

in which case the axial orifice o is cutoff from both bottles, while the pump is, through its connections with the orifice a, in communication withy the open air through recess V and air-orifice q, the pump being also in commu nication with the injecting-bottle B through its connections with the orifice n', channel S, orifices Z and g, (the chai1neli,which has communicating orifices Z and n, having been moved to an idle positi'on.) In the fourth positionthat shown in Fig. 9-the liquid contained in the injecting-bottle B may be injected directly into the cavity operated upon, in which case the axial orifice o', through its radial orifice o and the orifices 7c and f, and the connection between the two, is in communication with the injecting-bottle B, while the pump, through its connections with the orifice a', channel 'I,I orifices Z and g, and connections, is in communication with said bottle, and the pump being also in communication with the open air through its connections with the orifice n, recess V, and air-oriee p. v

The arrangement of the orifices, channels, recess, and connections being as described,

the practical operation of the instrument is as follows:

The instrument is prepared for use by filling or partially filling the injecting-bottle B with the liquid to be injected while the suction-bottle A is empty, and they are both carefully stoppered. The instrument attached to the tube t of the axial orifice o of the valve (say, for instance, the cannula of a trochar) is placed within the pathological cavity to be acted up` on by either suction or injection.

First. Let it be assumed that a vacuum is first to be produced wi thin the suction-bottle A and that thelatter is then to be connected with `the pathological cavity, so thatit may exhaust the morbid liquid contained therein, that irnmediately after this exhasstion an antiseptic or modifying liquid is to be injected into the said cavity, an d, on having remained therein for a. variable space oftinie, is to be removed therefrom again by suction. (Example: athoracocentcsis; a pleuritical effusion to be evacuated or a purulent collection to be removed; an antiseptic injection to be made into the pleural cavity, the liquid to he subsequently drawn out again.) To effect this I first bring the valve-plng R to the position shown in Fig. (i. Then by setting pump H into operation I draw in air from the suction-bottle and dischargeit into the atmosphere by the air-orifice T. The orifices o and o connecting with tube t, which leads to the cannula of the trochar, thus re mains closed. \Vhen the rarcfaction of the air within bottle A is found to be sufficient, I tu rnthe cont rolling-valve to the position shown in 7, thus opening communication between the tube 't and the suction-bottle. The liquid from the pathological cavity will, by reason of the partial vacuum produced in said bottle, run into the same. After a. space of time deemed sufficient for the whole ofthe liquid to be evacuated, aided, ma) be, by a suction-stroke ofthe pump, the controlling-valve will be brought to the position shown in Fig. 9. In the meantime the operation of the pump undergoes no change what ver. External air isthus drawn in through the liquid from the latter into the pathological cavity. \\"hen the amount of liquid thus injected is deemed sufficient, the injection isi stopped by bringing the coiitrolliiigvalve into the position shown in Fig. S, andthe same will be returned to the position shown in Fig. 7 when it is required to removethe liquid again from the cavity.

Second. Suppose that thc apparatus is to act successively by injection and suction.. (Example: the plcura to be washed after the foregoing operation, this washing to be continued until the liquid used leaves the cavity in a perfectly pure state.) For this purpose the assistant actuating` the pump may continue his work as before, withoutihe slightest alteration, and the controlliiig-valve is only carried from the position shown in Fig. 7 to that shown in Fig-.9.

Third. In the course of the operation, be-

orifice p, and caused to pass into the injectingbottle B, and force the fore it is completed it happens that one of the bottles is to be displaced-either the suctionbottle, in order to be emptied, or thc injectingbottle, to be filled anew. To this end it will suffice to bring the controlling-valve to 011e ofthe two positions shown in Figs. 6 or 8, which correspond tothe closing of the oritice o, communicating with the tube t carrying the cannula. Thus the interior of the cavity is no longer in communication with the atmosphere. Then by disengaging lever F from the central rod, D, of the apparatus, all the upper part of the latter is lifted, the bottles are emptied, filled, cleaned, etc., and finally put in place again. Now, lever F, which had been lowered, is lifted .and tightened, as before, and the whole of the apparatus assumes the same position as in the beginning of the operation, without its having been necessary to touch any one ofthe parts in contact with the patient. This operation can be repeated as many times as may be desirable. It is accomplished quickly and safely, and no inconvenience whatever results therefrom for the patient.

Fourth. Suppose, now, that an injection is to be very powerful. (Example: an injection into a fistulons course; an anfractuous wound with seats ofpurulcnt collections to be washed.) The controlling-Valve R is ti rst placed in the position shown in Fig. S. Then pump H is set in operation, and when the pressure isjudged high enough in the injecting-'bottle B the controlling'valveis brought to position shown in Fig. 9.

Fifth. Then it is desired that the liquid to be injected should be absolutely aseptie, so as to convey no germ whatever into the morbid cavity. (Example: an intra-renal injection.) Orificcs o ofthe controlling-valve, the one of tubetleading tothe cannula, the tuhej, as well as the vessel, are fustofall carefully washed by means of an antiseptic liquid. Then before commencing the operation, a tilter of wadding, hereinafter described, is screwed into thc air-channel g of stopper L of theinjectingbottle. The apparatus is now set in operation, and the injection is sure to be absolutely ascptic, as no germ can be carried into the distributcr by the circulating air, since the latter only reaches the surface of the liquid on having' been filtered through the wadding. In this case thcapparatus should be charged with liquid down to the very cannula before theinsertion ofthe latter into the vein, so as to eX- clude therefrom even the smallest bubble of air. The waddingviilter u, before referred to, consists of a tube, n, (see Fig. 5,) depending from the channel g into and near the bottom of a closed tube, al, which, like the tube e, is also attached at its upper end to a piece of metal. adapted to be screwed to the under side of the stopper. The closed tube .c at or near its top is provided with small criticos `i/for the exit of air, and the spac between the two tubes, is filled with wadding, through which the air is to be filtered. It will be understood that one of the bott-les may be provided with a press ICO ure-gage, and the other with a vacuum-indieator, or both may be connected with an apparatus recording the two. In a word, the apparatus,arranged as herein described,enables,

by simply operating pump I-I and turning the controlling-valve It to the proper position, a preparatory vacuum to bc produced in suction-bottle A, or a direct exhaustion to be ef fected without a preparatory vacuum, or a d1- rect injection to be performed from the injecting-bottle I, or, lastly, a suitable amount of airto be compressed within said bottle B before the injection is commenced, and the positions of the controlling-valve to obtain these various effects will be facilitated by the indeX pawl or4 hand w, before described. It will therefore be seen that thc handling of the apparatus is exceedingly simple. and that by its use no mistake is possible. The casesin which Y it may be successfully employed are of course very numerous, viz: first, various tappings,

pleurisy, pericarditis, ascites, abcesses, hydrocele, tappings of the bladder, 85e.; second, medicinal washings or injections directly after a tapping; thi rd,intra venal injections, (artificial serum, blood freed from tbrin, &c.; fourth, in testinal encmas with varying pressures; fifth, irrigations and washing of wounds, nasal and ocular douches, &c.; sixth, washings ofthe vagina, the uterine cavity, the bladder, Src.;

seventh, artificialfeeding,washing, and cleansing of the stomach, &c. In fact, by means of the perfectly-tight joint s and the india rubber tube t, the apparatus may readily be connected with a variety of instruments, such as trochars, cannulae, sounds, &c.

l. A combined exhaustingatd injecting apparatus consisting of a pair of bottles, a singleconveying-tube, a pump, and a controllingvalve common to said bottles, tube, and pump,

channels and the conveying-tube and pump, of a controlling-valve interposed between the channels of the stoppers, conveying-tube, and the pump, wherebyeither bottle is put into communication with the pump, either bottle is put into communication with the conveying-tube, and either bottle is put into communication with both the conveying-tube and the pump, vsubstantially as described.

4. The combination, with a pair of bottles having Stoppers, of a rod, E, provided with a beam, I, that is connected with both stoppers, whereby the said rod Will simultaneously raise or lower said Stoppers to close or open the mouths of said bottles, substantially as described. Y

5. The combination, with a pair of bottles having Stoppers provided with channelsf g,

yof a rod, E, provided with a beam, I, that is connected with both Stoppers, and a controlling-valve, also carried by said rod and having connections with said channels-whereby the said rod will simultaneously raise or lower said stoppers to close or open the mouths of said bottles Without disconnecting the valve from the channels, substantially as described.

6. The combination, with a pair of bottles having stoppers connected together by a beam, as I, of a rod, as E, connected to said beam and proyided with a hold-down lever, F, engaged by a'nut of screw-threaded rod G, substantially as described.

7. Theicombination, with a single conveyl ing-tube, t, and a pair of Stoppers for closing the mouths of a pair of bott-les,.and having channels therein, of a controlling-valve having an orifice for the tube and an orifice for each channel of the Stoppers, and for a pump and a valve-plug having orifices, channels, and recess controlling communication between said conveying-tube, channels in the Stoppers, and the pump, substantially as described.

8. The combination, with the inductionchannel of the stopper L, of a filter consisting of the open tube c and closed tube x, having air-orifices near its upper cnd and filled with antiseptic wadding,substantially as described.

In testimony whereof I have signed my name to this specification before two subscribing witnesses. l

ARMNI) EDOUARD ALBERT RUAULT.

Wtnesses:

DAVID T. S. FULLER, ALBERT CAHEN.

IOO 

